This invention relates a device for prevention and treatment of shoulder subluxation in patients with neurological dysfunction, such as stroke, or a number of other conditions that would impair the stability of the glenohumeral joint.
A stroke is an acute onset of neurological dysfunction caused by a malfunction in cerebral blood circulation which results in functional deficits congruent with the corresponding focal areas that are involved. A large variety of clinical manifestations may occur including varying levels of consciousness, sensory, motor, cognitive, perceptual, and language deficits. For the purpose of this background we will speak of the motor deficits involved that deem this device necessary.
In the initial stages of this disease process the patient will be flaccid: the patient has no voluntary control, muscles lack tone, and movement is not possible. During this flaccidity period of the cerebral vascular accident proprioceptive control may be shut off. This combined with the lack of tone and muscle paralysis decrease the support and normal seating of the rotator cuff muscles, especially the supraspinatus. The ligaments and capsule now becomes the shoulder's sole support. With the weight of the arm and gravity these structures may become stretched out and thus result in a shoulder subluxation. The gravitational forces and constant traction will result in persistent misalignment which will later cause pain.
Due to the fact that a stroke often impairs one side of the body many patients will find it hard to operate a traditional sling or as a matter of fact any arm sling. The dexterity of the effected side is compromised and the use of the one good arm is often insufficient to tighten the sling; the present invention is developed to accommodate this problem.
U.S. Pat. No. 5,188,587 of McGuire et al. discloses a shoulder brace comprising a shoulder sleeve and a plurality of straps. While the device serves a rehabilative function for the shoulder joint, it does not conform to individual body contours and asymmetries. Furthermore, the McGuire et al. device does not adequately serve the function of treating shoulder subluxation for there is no mechanism of adequately lifting the humerus into the glenoid fossa. Rather, strap 206 is shown to depress the acromioclavicular joint which may cause further orthopedic problems.
U.S. Pat. No. 4,446,858 of Verter discloses a shoulder brace that serves to support the arm and shoulder in the event of lack of muscle tone and ligament integrity, as is the case in shoulder subluxation. While the device adequately serves this purpose, it does not allow the user ease of independent application without the help of another individual. Similar to McGuire, the device does not contour to different body shapes and asymmetries. This may result in areas of increased pressure which may cause pressure ulcers in patients with reduced tactile sensation. Indeed, pressure applied by the device is not uniform over the applied area.
It would be advantageous to the shoulder subluxation patient if the aforementioned deficiencies were addressed. It is the object of the invention to provide a shoulder brace that will maintain the integrity of the shoulder joint. It is a further object of the invention to provide a brace that will provide ease of independent use. It is a further object of the invention to provide a brace that will adjust to an individual's body counters and asymmetries to provide uniform support of the shoulder joints. It is a further object of the invention to provide a shoulder brace that will maintain the position of the humerus in the glenoid fossa and prevent shoulder subluxation.